| Object iveTinnitus is a sensation of sound in the ear or the head without an external sound, which usually accompanied by irritability, insomnia, anxiety, and depression and so on. To the worse cases, work, entertainment and social communication can be seriously impacted. Up till now, we still do not clearly know the mechanism of tinnitus, and there is no definite therapy to cure it. It is generally accepted that tinnitus is only a symptom of other diseases, So once the tinnitus appears, naturally it is diagnosed as one symptom of the disease, but most of the time there is no good explanation that why the disease is cured while the tinnitus is still there. In recent years, some academics had suggested that tinnitus can be both the symptom of certain diseases and an independent disease. It will be an important research topic that when tinnitus is the symptom of other diseases or an independent disease. Initiating the research from the characteristics of tinnitus in different diseases maybe help us answer this question. In order to provide valuable clinical information for further study of the etiology and pathogenesis of tinnitus, we had chosen Sudden Sensorineural Hearing Loss as a starting point to investigate detailed tinnitus information and collect four diagnostic information, get basic data, learn about the incidence and characteristics of it. It may provide a reference for syndrome differentiation of traditional Chinese Medicine to study the tinnitus’incidence and characteristics of patient with Sudden Sensorineural Hearing Loss.Methods Collect the inpatients with Sudden Sensorineural Hearing Loss whose age ranged from14to75years old and were treated in ENT Department of the First Affiliated Hospital of Guangzhou University of TCM from January2005to December2011. Patients with severe primary disease or mental illness, pregnancy or lactation, combined with the other ear disease, suffered from tinnitus before Sudden Sensorineural Hearing Loss happening were excluded. Firstly, whether the tinnitus existence should be identified, then, collect the information of four physical examinations, if one has tinnitus, ask his subjective sensation in detail and whether his tinnitus and hearing loss appeared at the same (separated by not more than2days are considered at the same time), Then take the tinnitus psychoacoustic tests (including the tinnitus frequency, loudness, masking curve, residual inhibition), and tinnitus severity assessment, treated in TCM syndrome differentiation through the four combining information, observe the tinnitus and hearing recovery whether synchronization through the four combining information. If the synchronization recovery from tinnitus is a paroxysmal symptom, if not that tinnitus is not related to sudden deafness. There may be another reason. Analysis of tinnitus incidence and tinnitus characteristics of patients with sudden deafness, and analysis of the relationship between tinnitus incidence and characteristics of different syndromes by SPSS statistical software(17. Otype).Results1. Tinnitus’incidence of Sudden Sensorineural Hearing Loss(1) General information:There are364cases (364ears) with Sudden Sensorineural Hearing Loss. Among them, the male are179cases (49.2%), female are185cases (50.8%). left ear are195cases (53.6%), right ear are69cases (46.4%). Age from14to75years, average for43.96±15.66years. Course of disease from1day to1year, the average is16.9±36.0days. Course of treatment from3to73days, the average is18.4±10.1days. TCM differentiation:external invasion type are10cases (2.7%), Into the disturbance type are18cases (4.9%), phlegm fire disturbing upper type are79cases (21.7%), Qi stagnation and blood stasis type are12cases (3.3%), Kidney deficiency type are8cases (2.2%), Deficiency of Qi and blood type are237cases (65.1%).(2) The tinnitus’incidence of Sudden Sensorineural Hearing Loss:In the selected364cases of Sudden Sensorineural Hearing Loss, the cases without tinnitus are43cases (43\364,11.8%), with tinnitus are321cases (321/364,88.2%), including synchronization238cases, non-synchronous retreat83cases. So, the real tinnitus cases related to Sudden Sensorineural Hearing Loss are238, the tinnitus occurred at a rate of65.4%(238/364).(3)The tinnitus’incidence of different syndromes Sudden Sensorineural Hearing Loss:external invasion type is70.0%, Into the disturbance type is66.7%, phlegm fire disturbing upper type is74.7%, Qi stagnation and blood stasis type is91.7%, Kidney deficiency type is62.5%, Deficiency of Qi and blood type is60.8%.There is no significant difference in the incidence of different types.2. Tinnitus’characteristics of Sudden Sensorineural Hearing Loss(1) General information:In this study, from2005to2010data for retrospective study data, the tinnitus characteristic aspects of the record is not complete,2011January to2011December information for prospective study, tinnitus characteristics were recorded more comprehensive, so we choose the latter as the research data of tinnitus characteristics with Sudden Sensorineural Hearing Loss, a total of99cases (99ears) included in the study, Among them, the male are51cases (51.5%), female are48females (48.5%), left ear are52cases (52.5%), right ear are47cases (47.5%). Age from15to74years, average for41.1±15.2years The shortest course of one day up to eight, an average of16.0±37.8days. Course of disease from1day to8months, the average is16.0±37.8days. Course of treatment from3to73days, the average is16.8±11.6days. In99cases, tinnitus are90cases (90.9%), including synchronization64cases, non-synchronous retreat26cases.(2) the tinnitus’characteristics of Sudden Sensorineural Hearing Loss: tinnitus often occurs in the affected side, it occured with hearing loss at the same time, it often is described most like cicada chirp, in sound psychoacoustic test, most of the tinnitus frequency is the high frequency, the average is4141.0±3134.9Hz, loudness majority (92.2%) does not exceed5dBSL, the average is2.9±1.6dBSL, the minimum tinnitus masking curve are the overlapping and non-shelter type in the majority, the average inhibition is36.4+42.7seconds, most tinnitus patients with stage II, III evaluation.(3) The tinnitus’characteristics of different syndromes Sudden Sensorineural Hearing Loss:deficiency group are80cases, the average of tinnitus frequency is3959.4±3096.6Hz; the average of loudness is2.7±1.5dBSL; the minimum tinnitus masking curve are the overlapping and non-shelter type in the majority; the average inhibition is33.4±45.7seconds; the majority of tinnitus severity is stage III.Empirical group are10cases, the average of tinnitus frequency is4300.0±2213.6Hz; the average of loudness is of2.8±1.9dBSL; the minimum tinnitus masking curve are the overlapping and non-shelter type in the majority; the average inhibition is34.7±41.6seconds; the majority of tinnitus severity is stage III.After examination, deficiency and empirical group tinnitus characteristics (frequency, loudness, masking curve, residual inhibition, tinnitus severity) had no significant difference (P>0.05).Cone l us ion1. In this study, we survey364cases of Sudden Sensorineural Hearing Loss patients randomly, the rate of occurrence of tinnitus was88.2%, the incidence of tinnitus was65.4%. It suggests that almost90%of patients have tinnitus, among them, about3/4of the tinnitus may be one of the symptoms of Sudden Sensorineural Hearing Loss, about1/4of the tinnitus may be associated with it. The incidence of tinnitus between different syndromes occurs has no significant difference (P>0.05).2. The preliminary investigation of90cases of Sudden Sensorineural Hearing Loss associated with tinnitus suggest:tinnitus often occurs in the affected side, it occurs with hearing loss at the same time, it is often described most like cicada chirp, in sound psychoacoustic test, most of the tinnitus frequency is the high frequency, loudness majority does not exceed5dBSL, the minimum tinnitus masking curve are the overlapping and non-sheller type in the majority, most of residual inhibition is positive, and most tinnitus patients with stage II, III evaluation. The characteristics of tinnitus between different syndromes has no significant difference (P>0.05). However, due to the limitations of time and conditions, the sample size is relatively small, so the above tinnitus characteristics are representative, yet to be confirmed by further studies in the future. |
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